PD-L1 Expression is Increased in Metastasizing Squamous Cell Carcinomas and Their Metastases

Irene García-Díez, Eugenia Hernández-Ruiz, Evelyn Andrades, Javier Gimeno, Carla Ferrándiz-Pulido, Mireia Yébenes, Vicenç García-Patos, Ramón M. Pujol, Inmaculada Hernández-Muñoz, Agustí Toll

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24 Citations (Scopus)


Copyright © 2018 Wolters Kluwer Health, Inc. Programmed cell death ligand 1 (PD-L1) expression by tumor cells plays an important role in the inhibition of T cell-mediated immune response in cancer. PD-L1 expression by tumor cells has been linked to poor prognosis in a wide variety of cancers. However, PD-L1 expression in cutaneous squamous cell carcinoma (cSCC) has been scarcely studied, and its role as a prognosis biomarker remains controversial. The association of PD-L1 expression and the metastatic risk in a series of cSCC was assessed. PD-L1 and CD8 immunostainings of full excision sections of 99 primary tumors and 24 lymphatic metastases were semiquantitatively evaluated. Primary cSCCs were grouped according to the development of lymphatic metastatic spread [metastasizing squamous cell carcinoma (MSCC)] (n = 48) or the absence of progression [nonmetastasizing squamous cell carcinoma (NMSCC)] (n = 51). PD-L1-positive expression (cut off ≥1%) was found in 26% NMSCCs and in 50% MSCCs (P = 0.02). PD-L1 association with an increased metastatic risk was confirmed in the multivariate analysis (P < 0.05), along with the following features: recurrence, poor differentiation, and perineural invasion. Ninety percent of the metastases of PD-L1-positive tumors were also positive for PD-L1, displaying a trend toward a higher PD-L1 expression when compared with their primary tumors (P = 0.058). No significant differences in the peritumoral inflammatory infiltrate or in the expression of CD8 were found between metastasizing and nonmetastasizing primary tumors. Our results suggest that PD-L1 may play a relevant role in metastatic spread and may be a candidate prognostic biomarker in cSCC.
Original languageEnglish
Pages (from-to)647-654
JournalAmerican Journal of Dermatopathology
Issue number9
Publication statusPublished - 1 Sep 2018


  • CD8
  • PD-L1
  • cutaneous squamous cell carcinoma
  • metastasis
  • prognosis


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